In the confusing world of diet advice, how refreshing would it be if there were a study to end all studies? One that delivers the final word on what’s actually good for us. Well, in the name of clarity, the American Heart Association (AHA) has published a fool-proof assessment of the 10 most popular diet plans. In the first study of its kind, diets are ranked by how well they improve heart health.
“People are rightly confused about what and how to eat,” says nutritionist TC Callis, author of The Building Blocks of Life: A Nutrition Foundation for Healthcare Professionals (CRC Press), who used to work for the UK government on food regulation.
“The NHS EatWell guidelines in the UK don’t make a great deal of sense and are very poorly communicated. In the absence of trustworthy advice, people turn to social-media influencers who sell them the idea that you can live healthily by following fad diets, for example raw food. It’s deeply concerning and can be massively harmful.”
The AHA guidelines chime with those from the British Heart Foundation (BHF) and include the core principles of a heart-healthy diet: plenty of fruit and vegetables, wholegrains wherever possible, some meat, fish, eggs and plant-based protein and to limit sugar , salt and alcohol intake.
Rating the diets on a scale of one to 100, the AHA’s leader board looks like this: The Dash (Dietary Approaches to Stop Hypertension) eating plan (100); pescatarian diet (92); Mediterranean diet (89); vegetarian diets (86); vegan diets (78); low-fat diets (78); very low-fat diet (72); low-carbohydrate diets (64); palaeolithic (53) and very low-carbohydrate or ketogenic diets (31).
“What we eat affects a number of the different risk factors for heart and circulatory disease, including blood pressure, cholesterol and weight,” says Victoria Taylor, BHF’s senior dietitian who says her recommendations align with the AHA’s top 10 diets for heart health below.
If more of us are inclined to follow the diets at the top of the AHA’s list, it can only be a good thing, says TC Callis. “As a trusted voice in this space, the AHA has highlighted the good basic guidelines for eating by that reoccur in each of its top-ranking diets. Fill your plate with plants, but not exclusively. Stay away from anything ultra-processed and eat real food, which involves peeling, chopping, cooking and chewing.”
Even healthcare professionals are starting to see the importance of a food-first approach. Dr Syed Ahsan is a consultant cardiologist and heart rhythm specialist at London Heart Clinic. “I think the AHA’s guide is also a useful tool for healthcare professionals like me who are beginning to look at health more holistically.
“In the past we have been guilty of being a bit insular in how we approach treatments – perhaps prescribing medication for high cholesterol rather than looking into the lifestyle factors contributing to it,” says Dr Syed. “Now, I work with dietitians to look at a patient’s lifestyle and diet – the Dash diet emphasizes the advice I would give patients.”
Here, in descending order, are the heart experts’ top 10 tips for cardiac health.
1. The Dash (Dietary Approaches to Stop Hypertension) Eating Plan
Ticking all the boxes, the Dash diet – which was purposely designed to reduce blood pressure by US researchers at the National Heart, Lung, and Blood Institute (NHLBI) – limits salt, sugar, alcohol and processed foods and promotes eating lots of plant- based proteins including legumes, beans, nuts with the occasional addition of seafood and meat.
A diet rich in fiber, calcium and whole grains – all of which help reduce cholesterol and our risk of heart disease – gets a thumbs up from nutritionist Dr Somi Igbene. “Eating less salt is going to reduce your risk of high blood pressure and eating some fish is going to boost your intake of omega-3 fat, which gives you more of the ‘good cholesterol’,” she says. All the food groups are in there, so it’s therefore sustainable and adaptable for different cultures.